Tag Archives: Wellness

Health Care, Values, & Obligations: What Are Taxes Meant For?

dsc_0588“I like to pay taxes. With them, I buy civilization.” –Oliver Wendell Holmes Jr.

Hello friend,

Have you ever been in the middle of one of your most mundane daily activities—exercising, depositing money at the bank, adding two numbers, driving to the grocery store, tying your shoes, stuff like that—doing your thing the way you have always done it, when someone comes along and points out a totally different way to do it? Or maybe they even ask you why you are doing it in the first place? Suddenly you are forced to defend something you have never even thought about before. You have always just done it. It’s how you learned, and you never considered another way. Never even realized there was an option. But then there it is, right in front of you. It seems so obvious that you cannot believe that you didn’t notice it all this time. And here you are, your mind freshly blown, with a workout that suddenly has you losing weight, doing “new math,” banking online, having your groceries delivered, or using the “Circle Technique” on your laces. It seems crazy! Has that ever happened to you?

I think that is happening to me with health care. I suppose it has been happening for many years, but it feels sudden. My mind is spinning with a new possibility that was there all along.

Let me just say up front what I want and why. I want “free” health care for all people, and I want it because ensuring people’s health and well-being is at the core of the kind of common human decency that I believe we owe to the people we share space with.  

I could go on and on for pages about the Why part, but let’s get right to the meat of things. I look at health care like any other thing that our parents and grandparents believed was the job of the government–using our tax dollars–to provide for our care and convenience. Without any of us even thinking about it, of course our tax dollars pay for a police force, the fire department, streets and highways, a sewer system, drinking water, a strong military, elementary and high school education, and environmental protection.

Seriously, have you questioned lately why we all pay taxes on those things? Have you ever questioned it? I haven’t. And when I do question them now, my answer is, “Of course I am willing to pay taxes to fund those services. They exist to provide my most basic needs and things that I value: protection from hostile forces, safe travel, order in my neighborhood, health, safe food and drink, education.” I can’t imagine ever opposing chipping in for those basics for all people. They are what I would deem essential, and no more for me than anyone else. I won’t say it is technically everyone’s “right” to have these basics, but it reflects our basic human decency that we see them as essential for all. Therefore, it is our obligation to provide them.

If you are with me so far, I think now is a good time to sneak in my basic question: How is health care NOT on that list of essentials? Honestly, I am trying to see how it differs and am struggling for answers. The only thing I can come up with is that, “It’s just how it’s always been in America.” (And, I must add, only in America.)

I suppose we all have the same blind spot I had until recently! I don’t think I am the only one who, if pressed for an answer, sees caring for the health of all as at least as important as providing fire protection for all or education for all. I don’t want to get into splitting hairs here since I have already deemed them all essential, but if forced, I don’t think it would be farfetched to suggest that, of those three just mentioned—health, fire protection, and education—health care just might be most important. In any case, I have yet to hear an argument that kicks it off the list.

But perhaps you want to quibble. Maybe you think the health and well-being of your neighbors should not be your concern, and anyway, you aren’t interested in paying more in taxes to help them out. They aren’t that valuable. So let’s look at some of the other stuff you regularly pay taxes for. As we do, try to build a sort of ranking system for how important—indeed, how essential–you believe these are relative to your own health and that of others you know. Here are just a few:

  • City parks
  • Space exploration
  • Street sweeping
  • Recreational programming
  • Subsidies for agriculture and big oil companies
  • The Arts
  • Lifetime salaries for Senators and Congressmen
  • National Parks
  • Science research
  • Zoos
  • Corporate Bailouts (e.g. the auto industry or Wall Street)
  • Libraries
  • Snow removal

We could go on and on, of course, as our taxes go to so many different and important things. How is your ranking system going so far? I won’t bore you with how I rank them. I will only say that I don’t value any of them—value them for me or for others (and believe me, I really love libraries!)—more than I do health care.

I really want to make clear here that, before all of the defenses go up and we have to start battling each other about how we could pay for it, I am just trying to establish an agreement on what we VALUE. It is a separate issue. My point is that if we all agreed with me (this happens in my dreams, and it’s fabulous!) in thinking health care was at least as important (even essential) as things like education, clean water, and the police, then, logically speaking, we would be forced to agree that we ought to be willing to ensure equal access to health care for everyone by taking care of it with our tax dollars. By extension—and this is the painful realization part—if we have agreed on what we value and yet still fail to act to make it right, we are failing a moral obligation.   The blood of the uncared for is—literally and figuratively—on our hands. I am not okay with that.

I know, I know, you probably wanted to skim through that last paragraph really fast and get to the part where you defend your side by saying it is too expensive and our system is broken and it’s not your fault and such. I feel you. I really do. That’s why I think it is important to first separate the argument so that we are not conflating what we value (morally speaking) and what we are eager to pay for (financially speaking).

And believe me, I make no claim that I am any kind of an expert on how much everything costs and how much more or less we would pay if we blew up our system entirely and went to a single-payer system (a.k.a. socialized medicine, universal health care, or government-run health care). As a total amateur on these topics, my sense is that we already pay a ton for insurance premiums, co-pays, and deductibles, and it also seems like pharmaceutical companies charge through the roof and own so many of our representatives in Washington, DC. My guess is that if the insurance industry was dismantled and the pharmaceutical prices were government-controlled, so much of that money that we now spend could go to getting everyone equal access to quality care. I am sure there is a down side of it, too, because at this point, who really trusts the government to run anything, right?

But we are Americans. We take pride in the idea that we are exceptional. It is supposed to be our thing to figure out the best way to do stuff, and then to keep leading the way with our exceptionalism. If we look at the examples of all the hundreds of other countries in the world who provide health care to their people, and if we see problems in their systems, I feel confident that we could figure out the solutions and move forward with a system that affirms in action what we claim to value (Because Love does, right? It doesn’t just say.). I feel like the “changing our system will be too hard” excuse is weak and lazy, especially if the result is immoral. I think we are better than that. I hope we are. I feel like it is time to put our money where our values are.

How about you? Is health care something you value enough to put your tax money down to guarantee it for everyone? Open up your journal and try to keep an open mind as you parse through this sticky issue. I think this is an especially tough one to tackle with an open heart and mind because, for many of us, it is just something we haven’t ever considered. Our system has been this way our whole lives, and a suggestion to change something long-held usually meets with defense as a first reaction (because of course we are right). So, take a breath, and start with logic. First, is your health valuable to you? How valuable? As important as your safety? Your education? Your water? Your public parks? The arts? Which of the things that you pay taxes for do you think are moral obligations of a society to provide for its people? Which are things that are great and you value, but they aren’t obligations or essential? Which things that you are taxed on do you feel are a rip-off? For the sake of argument, let’s say we had always been taxed for universal health coverage: where would it fit with your last three answers: Moral Obligation, Important-But-Not-Essential, or a Waste/Rip-off? Based on your answer, should single-payer/universal health coverage be a part of the American system going forward? Okay, if you were able to answer most of those logically, relax! Now, feel those natural defenses that probably came up when this issue arose. What makes you most squeamish about agreeing to include universal health care to your list of givens? Is it the money itself (that you think it is going to be much more expensive for you)? Is it that you don’t want to put anything else into the government’s hands? Is it that you don’t think some people deserve it or that too many people who aren’t taxed much because they are poor will take advantage of your hard-earned dollars by using the health care system as much as you do? Do you agree with my assertion that if we agree that health is of such importance to us that we deem medical care to be essential—like we agree on education and safety and the like—then we are morally obligated to provide it? If not, where is the flaw in my thinking? If my thinking is sound, then we are either failing morally on this topic or you disagree that health is of such importance. Which is it? Leave me a reply and let me know: Which things are worthy of your tax dollars, and how does health care fit into your priorities?  

See yourself in your neighbor,

William

P.S. If this made you really look at health care and taxes for the first time, or if it made you think of them in a new light that helped you clarify your position, I hope that you will share it with others. We owe it to ourselves to examine our values. May you be Peace.

An Unfriendly Reminder

DSC_0408“When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.” –Herophilus

Hello friend,

A little over ten years ago, I came to understand suicide more clearly.

Sure, I had spent time thinking about it over the years, but mostly in theoretical terms. I would hear about people killing themselves and always wonder, “Why?” In the tenderness of my youth, I wanted to believe I was so empathetic that I really could understand the depths of despair. When my first love broke my teenage heart, I was a mess inside. I was pretty far gone, but not so far that I wasn’t aware of my thoughts. Among other things, I thought a lot about suicide. Not actually doing it—I never considered it as an option—but about the concept of suicide. Being depressed for that short time really triggered something in me, a deeper intellectualization of suicide. I thought about it regularly: about how people’s emotions can turn an otherwise-clear mind irrational, and about how belief—whether rational or not—that one’s life has no hope for improvement can make ending that life seem like an appealing option. Traps of the heart and mind. That, in a nutshell, is how suicide appeared to me until about the age of thirty. And then, it all changed.

I herniated a disc in my lower back. I won’t go into the complete nightmare sequence of events led by the HMO-directed thinking of doctors who were way out of their expertise, but suffice it to say that in the end, I was literally stuck in a sideways-bent position for days on end as they continued to multiply the doses of narcotics but failed to get me the right tests and specialists to provide any relief. I distinctly recall sitting—if you could call it that—alone in my basement one afternoon, sobbing and wailing because it hurt so badly. It was in that moment, and in the ensuing days of agony that led up—finally—to my surgery, that I arrived at a new understanding of suicide. It wasn’t only about mental and emotional pain and despair, as I had previously believed. No, the ending of one’s own life could be deemed a desirable outcome if enough physical pain was involved for a long enough time. Again, much like when I was suffering from a broken heart, I didn’t actually consider killing myself during the episode with my back, but I surely thought about the concept often. My mind just gravitated to the topic. I put myself in the position of people who are suffering from some types of terminal cancer or other chronic, severe, and debilitating pain, and believe me, I completely understood their desire to end their lives “prematurely”. In that much pain and with no end in sight, it became easy to understand the “This isn’t living” rationale. If I weren’t being careful with my words, I would describe the kind of pain I was in as “unbearable”. However, at least I knew that a solution would come eventually, and with it relief. I knew I could lay down my burden; others are not so lucky.

Even though I have some lingering nerve damage in my leg from the blundering of those doctors that did not get me the proper care in time—yes, I am a little bitter still if you couldn’t tell–my essential health was restored eventually. There is a scar on my spine that will stay with me, but otherwise my body moved on. After a year, I had pretty well put behind me my medical nightmare and the horrific pain I was in for those dark days. One lesson I kept with me was to always try to maintain strength in my core muscles and overall fitness. The other lesson that I was sure that I would hold onto forever was to be grateful for my health every day that I have it. The incident had made me keenly aware of how precious and fleeting good health is—much like life itself—and thus how aware and grateful I should be each day to be alive and relatively pain-free. I vowed to never forget. How could I?

Well, I did forget. I got complacent. I did the right things physically to try to avoid another disaster, but I got sloppy with the gratitude part. I stopped reminding myself what a magnificent gift it is to wake up and breathe easily in the morning, to be able to wrestle with my kids and give them shoulder rides, to run around and hit tennis balls, to survive a hot yoga class, and to simply walk the earth without the distraction of pain. Sure, I have had pretty regular injuries to remind myself what a hassle they are, but mostly I have been able to press on and continue an active life. And, I am sad to admit, a blindly ungrateful one, too.

It seems that the better my health has been, the less grateful for it I have been. For me at least, it is the biggest one I let slip through the cracks when it comes to prayers of gratitude. I feel like I am pretty self-aware when it comes to how lucky I am to have such wonderful people in my life. My parents and siblings are the best ever, and I wouldn’t trade any of them in. I can hardly imagine my luck in finding someone who actually chose to have me around for life, so, needless to say, I am grateful for my amazing wife. And of course, my kids are the greatest things that have ever happened to me. I feel like I know that every day, too. I am so aware of how they make my heart overflow, so I pretty much ooze gratitude when it comes to them. I know, too, how lucky I am to be allowed a schedule that matches my priorities, offering me tons of quality time with the family, as well as some stolen moments to pursue my passions, such as writing this letter to you. I am well aware of how spoiled I am in this regard, so I am deeply grateful.

I always tell people that one of the biggest benefits of keeping a daily journal is that it makes me intensely self-aware, and that the main benefit of this self-awareness is gratitude for my beautiful existence. As I said, I feel like this is very true in all of the other areas of my life. So, why do I do so poorly in acknowledging the blessings of good health? Being a sports lover, the analogy that comes to my mind is of the referee (or the ballkids in tennis). The goal of the referee—or the ballkid—is to NOT be noticed. If you notice them, it is probably because they are doing a bad job. Health seems to be, for me, like that. If I don’t notice my health, that means the job is being done well. If I do notice it—like this past week, when my spine has again gone awry and left me agonizing—something is wrong. I can see now—pain sometimes has a way of clarifying things—that this is not fair to my health. I am hereby vowing to do a better job of acknowledging—DAILY–the wonderful fortune it is to be in good health. I love Herophilus’s quote at the top of the page; it really is true that without health, our other gifts cannot shine through. I am so driven to maximize my potential, so I would be a fool not to honor the instrument through which all things flow. Like with so many people around us, a simple show of gratitude and respect can do wonders. It is time I started to set things right. I am only sorry that it required this week’s unfriendly reminder from my spine to help me see the light.

How about you? How is your relationship with your health? Open up your journal and start writing. Make a list of the aspects of your health that you appreciate. Can you make it through the day without pain? Do you require any medications or devices to function normally? Do you like a good fitness challenge? Do you sleep comfortably? Are you able to “act like a kid” sometimes, full of energy and freedom? Can you run? Could you still climb a sledding hill? Jump in the pool or lake for a swim? Run through the sprinkler? Ride a bike? Chase a kid around all day? Do you set goals for your health and fitness? Do you go to a gym or have a regular workout routine? How is your diet? If you could change your weight any amount in either direction, what would you choose? Do you know of people who are less healthy than you? Perhaps they have cancer, cardiovascular disease, an autoimmune disorder, arthritis, or obesity. In thinking about them, does it make you more grateful for the health that you have? Does it motivate you to take action to improve your health? How grateful are you about your status? Are you like me and take it for granted when it is going well, only to be reminded of your ingratitude when you are stricken down with something? Leave me a reply and let me know: Do you appreciate your health, or does it require an unfriendly reminder? 

Start your day with “Thank you”,

William